Presentation (CTI)

OBJECTIVES: Cardiovascular diseases, particularly stroke and coronary heart disease, constitute the leading causes of mortality in Japan. Hypercholesterolemia represents a key modifiable risk factor, playing a critical role in the pathogenesis of atherosclerotic cardiovascular events. Patients who survive a primary cardiovascular event remain at heightened risk for recurrent, and potentially more severe, events. The aim of this study was to assess the risks of recurrent cardiovascular events and all-cause mortality in patients with a history of cardiac or cerebrovascular events, using real-world data.
METHODS: This study used data from medical institutions under the Diagnosis Procedure Combination system, sourced from Medical Data Vision (Tokyo, Japan). Cardiovascular events, including ischemic stroke (IS), myocardial infarction (MI), and unstable angina (UA), were identified using ICD-10 codes (IS: I63; MI: I21-I22; UA: I20.0) through Prospection’s analytics platform.
RESULTS: From April 2008 to March 2024, a total of 212,363 patients with primary cardiovascular events were included: 40,757 with UA, 75,050 with MI, and 96,556 with IS. Overall, the probability of experiencing a recurrent cardiovascular event was 7.83% within one year and 2.18% between one and two years after the primary event. Among patients with a primary MI, the one-year incidence of recurrent MI was 1.65%, UA was 2.81%, and IS was 0.57%, with a one-year mortality rate of 1.84%. Among those with a primary UA, the one-year incidence of MI was 0.49%, UA was 16.95%, and IS was 0.42%, with a one-year mortality rate of 0.26%. For patients with a primary IS, the one-year incidence of MI was 0.14%, UA was 0.35%, recurrent IS was 5.19%, and the one-year mortality rate was 1.75%.
CONCLUSIONS: Patients in Japan who experience a primary cardiovascular event face a substantial risk of recurrent events and death, highlighting the critical need for effective secondary prevention strategies.